In a dramatic reversal of the trend that existed just three years ago, big corporate hospitals today charge health insurance card holders much less than those paying in cash for the same procedures. Those paying out of their pockets are now billed anywhere between 25% and 60% more than those with cashless health insurance schemes.

Knee surgery without cover can cost Rs 2.44L

Treatment cost for patients without any insurance is 25% to 60% higher than for those with health insurance cards, a comparative study by TOI has found. This figure was arrived at after obtaining exclusive details of treatment costs paid to hospitals by four public sector insurers, commanding a 60% share in the health insurance segment, and tallied with the schedule of charges (price list) of these corporate hospitals for other customers.

For instance, the package for a heart surgery at Sir Ganga Ram, Max, Fortis, Apollo hospitals in Delhi, Medanta in Gurgaon if you are holding an insurance policy — and other corporate hospitals across the country in the same category – is about Rs 2.25 lakh. This charge is for single-room occupancy and covers all expenses, including coverage for complications if any, and a stay for seven days and if required more. For the same treatment, if you are making out-of-pocket payment, it will cost you an average of Rs 3.63 lakh.

For a caesarean delivery, these hospitals have been charging a fixed package of Rs 55,000 — whether it is Apollo, Fortis or Ganga Ram — for a cashless insurance card holder . A knee replacement can cost you up to Rs 2.44 lakh in any of these hospitals, but the same comes at a fixed package of Rs 1.60 lakh if you are backed by an insurance policy.
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